HCAO News

Health Care for All Oregon is a grassroots coalition of over 100 organizations that are determined to create a better way of financing health care for every person who lives or works in Oregon. Our mission is to provide publicly funded, privately delivered, high quality, affordable, universal health care to everyone. People will be free to choose their medical provider to give them the care that they need, free to choose their career, job, and time of retirement independent of health care costs. We believe that health care is a human right. The care we receive should not be dependent on what we can afford. It is time we joined the rest of the free world and provided ourselves with publicly funded health care just like we do for education, libraries, fire fighters, and police.

Congresswoman Cathy McMorris Rodgers posted an image on her official Facebook page, slamming the Affordable Care Act on the fifth anniversary of President Obama signing it into law. She asked constituents to share their Obamacare nightmare stories and well, the response probably wasn't what she expected. Below are a small sample of the comments constituents left on her page:

My story is that I once knew 7 people who couldn't get health insurance. Now they all have it, thanks to the ACA and President Obama, and their plans are as good as the one my employer provides--and they pay less for them. Now, that's not the kind of story you want to hear. You want to hear made-up horror stories. I don't know anyone with one of those stories.

It is URGENT that everyone who cares about the future of Medicare understands what is happening here.

H.R. 1470, the “SGR Repeal and Medicare Provider Payment Modernization Act of 2015,” was formally introduced in the House of Representatives only yesterday (3/19/15), with strong bipartisan support. The 158 pages (GPO pdf) introduced so far provide a mechanism for replacing the Medicare Sustainable Growth Rate (SGR) for determining Medicare payments, with a new Merit-based Incentive Payment System (MIPS).

Next week it is anticipated that the House will act on amendments that allegedly will help offset the cost of canceling payment reductions that would have taken place under the SGR system. Today’s message is limited to the new MIPS, but everyone should be alarmed about the amendments that are to be considered next week. Just two of them - greater means testing of Part B premiums, and requiring Medigap enrollees to start paying deductibles - will be very damaging to the egalitarian nature of our Medicare program.

The excerpts from H.R. 1470, above, reveal how the government intends to fulfill its goal of supposedly converting Medicare from a system that pays based on volume to a system that is based on value. Since the excerpts represent only a small sampling of this bill, it would be wise to download the full bill. You can gain a better understanding of the bill by skimming through the 158 pages, reading only the lines in full capital letters, while reading in full any section that piques your interest. It takes just a few minutes. That’s too much? Remember, this bill is about to become law and we will have to live with it perhaps for decades (the scorned SGR has been with us for 18 years).

Comments; 1) the author does not emphasize that Medicare in its current state is the most efficiently run insurance program in the country, 2) the author does not mention as cost-saving measures either the problems of malpractice reform or medical school debt, and 3) most relevant to HCAO, if there were a national single-payer health care system paid for by combination of income tax and VAT(ie ongoing sources of revenue), there would be no worry about depletion of the Medicare fund. Jerry Robbins MD, Newport

Many Americans have never known a world without Medicare. For 50 years, it has been a reliable guarantor of the health and welfare of older and disabled Americans by paying their medical bills, ensuring their access to needed health care services, and protecting them from potentially crushing health expenses. However, as popular as Medicare has become, Congress created the program only after a long and deeply ideological struggle that still reverberates in continuing debates about its future. Nor was the Medicare program that was signed into law by President Lyndon B. Johnson on July 30, 1965, identical to the program we know today. As we mark the beginning of Medicare's 50th anniversary year, this first report in a two-part series recounts the history of this remarkable health care initiative and explains how it came to be, what it has accomplished, and how it has evolved over the past five decades. In the second report in the series, we will describe the ongoing challenges of the program and discuss proposals to address them.

Part 2: Medicare at 50 — Moving Forward

As Medicare enters its 50th year, this popular federal program faces profound challenges to its effectiveness and sustainability in future decades. In this report, we review these problems, building on the issues raised in our earlier article.1 We also review several options to strengthen the program and enhance its viability.

Critical Changes Facing MedicareRising Expenditures

Perhaps the most important challenge facing Medicare is the prospect of increasing expenditures, driven in large part by demographic trends. As the U.S. population ages, the number of people who are eligible for Medicare benefits will grow, from 52.3 million in 2013 to 81.8 million in 2030.2 From 2009 through 2013, Medicare spending per beneficiary increased at a historically low annual rate of 1.0% in nominal dollars and actually decreased in real terms (accounting for inflation). Over the next decade, slow growth in Medicare spending per beneficiary is expected to continue, but because of substantial increases in the number of beneficiaries, the growth in total program spending will outpace that in the overall economy (Figure 1 Figure 1Projected Annual Growth Rates for Total Medicare Spending, as Compared with the Gross Domestic Product (GDP) and Medicare Enrollment, 2013–2023.). Total Medicare spending is expected to increase from 3.0% of the nation's gross domestic product (GDP) in 2013 to 3.8% in 2030, and the program's share of the federal budget is expected to increase from 14.4% to 15.8%.3 These fiscal trends will create continuing pressure to reform the program.

At one of my visits Wednesday with Lee Beyer I told him my story which I had made into a letter to editor. It is bellow for reference:

Drug price disparities are unfair Register Guard 9/1/2014 (Labor Day)I recently had a biopsy performed to check for liver damage due to hepatitis C. Medicaid excluded me from treatment because my liver looked good enough that they didn’t believe it will be the cause of my death.Talking to the doctor, I learned that Medicaid wouldn’t pay to treat my condition because of the cost: $84,000.He said I could take my prescription to Canada and buy the drugs there for $48,000. But that wasn’t what blew my mind; he also said for the price of a round-trip ticket to Iran or Saudi Arabia, or many African countries, I could buy the medication for a thousand dollars.What? Who says America’s the land of the free? Free to be ripped of by dog-eat-dog capitalism.I can’t figure out why pharmaceutical corporations are willing to bankrupt Americans while not doing the same to foreigners — after all, they only care about maximizing their profits.Gilead, the company that currently owns the intellectual property for the medication, will eventually lose some of its loot to other chemists who will modify Sovaldi just enough so it still works but is novel enough to be patented.Problems such as this are why the Affordable Care Act is far from what the Eugene group Health Care for All Oregon is advocating: single-payer or expanded Medicare for everyone.

I told Lee Beyer that our obstacles were the Insurance companies and the fact that we can't negotiate for prices with big pharma. He agreed about the Insurance, but said that negotiating with the drug companies is impossible because of a congressional clause which prohibits the gov't from bargaining with them. Some people think that the fact that drugs are cheaper in other countries means the big pharma companies are doing them a favor on the back of Americans who pay inflated prices. This is not so. Drug companies always get the most they can in any country. The fact that they negotiate fairly is credit to other countries' leaders and laws. It seems that if there are differences of 84 to 1 in American drug prices vs. say Saudi Arabia shows that this is one of the first problems to tackle: that congressional prohibition that inhibits fair business transactions and negotiating.

Also in a room full of people prompted by one of my questions, Chris Edwards disclosed that the Insurance companies have always offered him money. He said at first he turned it down, but then as he said "because I always vote against them I decided to take their money" "if they are dumb enough to give me money even though I vote against them, I'll take it". I am not mentioning this as an attack on senator Edwards, but I told him it was hard for me to believe the corporations would throw away money and really get nothing. And I told him health insurers are very powerful and they are not "dumb"; there might be strings invisible but real none the less.

"The global evidence is very clear: single-payer financing systems are the most equitable and cost-effective way to assure that everyone, without exception, gets high-quality care," physician activist say. (Photo: Alex Proimos/flickr/cc)

Single-payer advocates are celebrating the reintroduction of the so-called 'Medicare-for-All' bill that would replace the nation's byzantine healthcare system, dominated by private health insurance companies, with a single, streamlined public agency that would pay all medical claims for the entire population, much like Medicare does for seniors today.

Lead sponsor Rep. John Conyers Jr. (D-Mich) put forth the "Expanded and Improved Medicare for All Act" (H.R. 676) on Tuesday evening, along with 44 other House members. The legislation would create a publicly financed, privately delivered health care system that expands the already existing Medicare program to all U.S. residents and all residents living in U.S. territories. The bill has been defeated in three previous House sessions.

Proponents say the approach would vastly simplify how the nation pays for care, improve patient health, restore free choice of physician, eliminate co-pays and deductibles, and yield substantial savings for individuals, families, and the national economy.

This year marks the 50th anniversary of the Voting Rights Act of 1965 and of the enactment of Medicare. Not long ago, a U.S. Supreme Court dominated by Republican appointees gutted the Voting Rights Act, and a Democratic president who never could have been elected without it took Medicare for Everyone off the table when he proposed his much ballyhooed health reform.

The American Medical Association tried to defeat Medicare. It cleverly labeled all such proposals “socialized medicine.” Medicare isn’t socialized medicine. The VA health care system is socialized medicine. Its hospitals are publicly owned, and VA staff are salaried employees paid with tax dollars. Medicare is only an insurance program.

So Medicare didn’t threaten the livelihood of physicians. Instead, it added huge numbers of paying clients to their patient base. The AMA had identified the wrong threat. The real threat emerged in the 1980s. It was the private insurance industry, not public insurance, that drastically interfered with the practice of medicine.

Private insurance plans forced most physicians to join groups like health maintenance organizations, hospital systems, and other large groupings — some of them corporations interested in profits, not health care. Often physicians couldn’t treat their patients without approval for payment from the patients’ insurance carriers, whose on-staff medical personnel could second-guess the attending physician. In more subtle but ever-present ways, the imposition of a corporate model has distorted the practice of medicine and diminished the satisfaction of practitioners.

Here is a Youtube video showing my Fast Track/TPP question to Senator Wyden today in Grants Pass, Oregon, and also a quick description of the event. We did unveil a banner at the end--see photo. What a team effort! Hats off to Brother Ivend Holen.

Following the 10am town hall in Grants Pass we had legislative training for Health Care for All Oregon at 1pm in Medford. Then at 3:30pm east of here in Klamath Falls was the Wyden town hall over there at the Oregon Institute of Technology, OIT.

In Grants Pass, there was a mostly full Rogue Community College rather small auditorium, over 100 for sure, maybe pushing 150. I counted 10 of us who were there specifically for the ORFTC call to action. It got my number drawn for an early question which I started with by speaking about our poor economy and flat wages, how the recovery just wasn't happening for working people. I'm not going to try and quote my question right here, as we have it on video posted by Ivend Holen on youtube. More photos and/or video being sought.

So I'll jump to my ask at the end: Senator Wyden will you oppose fast track in 2015?... He said a bunch of nothing so I asked again, Senator will you oppose fast track? I ended up asking him four times publicly and he never would answer directly. Earlier at the start when laying ground rules for the town hall Sen. Wyden had made it clear, "ask a direct question and i'll give you a direct answer" I did ask him a fifth time not with a microphone in my hand and he said "I already answered you."Wes Brain, HCAO Rogue ValleyOregon Fair Trade Campaign Southern Oregon Jobs with Justice Health Care for All-Oregon

Former WellPoint VP Elizabeth Fowler sits behind her boss, Sen. Max Baucus, as he announces in 2009 that the health care bill will have no public option. Photograph: screen grab, Bill Moyers' Journal guardian.co.uk

Few people embody the corporatist revolving door greasing Washington as purely as Elizabeth Fowler

When the legislation that became known as "Obamacare" was first drafted, the key legislator was the Democratic Chairman of the Senate Finance Committee, Max Baucus, whose committee took the lead in drafting the legislation. As Baucus himself repeatedly boasted, the architect of that legislation was Elizabeth Folwer, his chief health policy counsel; indeed, as Marcy Wheeler discovered, it was Fowler who actually drafted it. As Politico put it at the time: "If you drew an organizational chart of major players in the Senate health care negotiations, Fowler would be the chief operating officer."

What was most amazing about all of that was that, before joining Baucus' office as the point person for the health care bill, Fowler was the Vice President for Public Policy and External Affairs (i.e. informal lobbying) at WellPoint, the nation's largest health insurance provider (before going to WellPoint, as well as after, Fowler had worked as Baucus' top health care aide). And when that health care bill was drafted, the person whom Fowler replaced as chief health counsel in Baucus' office, Michelle Easton, was lobbying for WellPoint as a principal at Tarplin, Downs, and Young.

Whatever one's views on Obamacare were and are: the bill's mandate that everyone purchase the products of the private health insurance industry, unaccompanied by any public alternative, was a huge gift to that industry; as Wheeler wrote at the time: "to the extent that Liz Fowler is the author of this document, we might as well consider WellPoint its author as well." Watch the five-minute Bill Moyers report from 2009, embedded below, on the key role played in all of this by Liz Fowler and the "revolving door" between the health insurance/lobbying industry and government officials at the time this bill was written and passed.

As we head into the final stretch before next week’s midterm elections, Americans continue to have wide-ranging views of Obamacare, but even many who have an unfavorable view of it say they would rather see Congress improve it than get rid of it.

In fact, according to the Kaiser Family Foundation’s most recent tracking poll of public opinion about the law, released last Tuesday, almost two-thirds of the public would rather see their member of Congress work to make the law better than to repeal and replace it.

The big, unanswered question, though, is what to fix and how to do it.

The leaked rules "are likely to affect access to important medicines such as cancer drugs and will also weaken the requirements needed to patent genes in plants, which will impact small farmers and boost the dominance of large agricultural corporations like Monsanto," according to WikiLeaks. (Photo: GlobalTradeWatch/flickr/cc)

U.S. pushing rules that 'favor big corporate right holders, and undermine the public’s freedom to use knowledge,' intellectual property expert says

WikiLeaks on Thursday released a second updated version of the Trans-Pacific Partnership (TPP) Intellectual Property Rights chapter, charging that it will hinder affordable access to medicines globally, increase online surveillance, and impinge on civil liberties while benefiting Big Pharma and other corporate interests.

"Our first impression in reading the document is the extent to which the United States has sought hundreds of changes in intellectual property norms, some small and subtle, others blunt and aggressive, nearly of all of which favor big corporate right holders, and undermine the public’s freedom to use knowledge," declared James Love of Knowledge Ecology International.

The TPP is the world's largest economic trade agreement that will, if it goes into effect, encompass more than 40 percent of the world's GDP. The IP chapter covers topics from pharmaceuticals, patent registrations, and copyright issues to digital rights.

Note to politicians: Backing “Medicare for all” is looking less and less like electoral poison. If, deep in your heart, you believe American health care would be better off with a Canadian-style, single-payer system, you might now consider coming out of the closet. (In Democratic primaries in blue states, at least.)

That’s my suggested takeaway from the striking Massachusetts Democratic primary showing of Dr. Donald Berwick, who rocketed from near-zero name recognition among general voters to 21 percent at the polls. Catch him saying forcefully in the video above: “Let’s take the step in health care that the rest of the country hasn’t had the guts to take: single payer. Medicare for all.”

Now, Vermont not only has a mainstream politician who backed a single-payer system — Gov. Peter Shumlin — it’s actually translating the idea into practice as we speak. But let’s put it this way: This seems to be the first time that a candidate in a mainstream political party in a state that is not a verdant utopian duchy has run on a single-payer platform. And though he did not defeat the longtime familiar faces, he did surprisingly well.

Dr. Monica Wehby’s condemnation of the Affordable Care Act (Register-Guard, July 31) is warranted. The ACA was not designed to provide universal access or reduce costs. It is not predicted to do so, even if it works perfectly.

However, Wehby’s hypothetical replacement for the ACA is an unsupportable fantasy. She believes our American private health insurance is the solution, not the cause, of our health care crisis. Wehby’s program says we must “guarantee protection for Americans who remain continuously enrolled in insurance plans.” But given that current insurance plans leave most families at risk for medical bankruptcy, there is little rationale to protect those plans.

Wehby says we must “allow people to buy insurance across state lines to spur competition and give consumers more options.” Imagine the billing boondoggle that would create! Cover Oregon already has 11 insurance companies on its exchange. With most companies offering plans in the bronze, silver, gold and platinum metal levels and for three markets (large group, small group, and individual), that’s a lot to keep track off. No wonder the state’s computer program failed spectacularly. Multiply that confusion by 50 states and you’ll see that Wehby’s proposal adds expense rather than reducing it.

WASHINGTON – Enrollment in health plans sold on marketplaces created by President Obama’s healthcare law has hit 4 million, the administration announced Tuesday, marking another milestone in the law’s implementation. The number suggests sign-ups have continued at a brisk pace in February, with about 700,000 people selecting an insurance plan so far this month.

Having failed to defeat the Affordable Care Act in Congress, to beat it back in the last election, to repeal it despite more than eighty votes in the House, to stop it in the federal courts, to get enough votes in the Supreme Court to overrule it, and to gut it with outright extortion (closing the government and threatening to default on the nation’s debts unless it was repealed), Republicans are now down to their last ploy.

They are hell-bent on destroying the Affordable Care Act in Americans’ minds.

A document circulating among House Republicans (reported by the New York Times) instructs them to repeat the following themes and stories continuously: “Because of Obamacare, I Lost My Insurance.” “Obamacare Increases Health Care Costs.” “The Exchanges May Not Be Secure, Putting Personal Information at Risk.”

Official:
agency failed to investigate 1,200 complaints due to staff shortages,
and more cuts comingBy
Fred
SchulteJuly
1, 2013 The Center for Public Integrity

Citing
massive budget and staff cuts, federal officials are set to scale
back or drop a host of investigations into Medicare and Medicaid
fraud and abuse — even though cracking down on government waste and
cutting health care costs have been top priorities for the Obama
administration.

The
Department of Health and Human Services Office of Inspector General
is set to lose a total of 400 staffers that are deployed nationwide
as a primary defense against health care fraud and abuse. Though
agency officials have yet to decide which investigations will be
shelved as staff dwindles, the existing staff is already stretched so
thin that the agency has failed to act on 1,200 complaints over the
past year alleging wrongdoing — and expects that number to rise.
The OIG began shedding staff at the beginning of the year.

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